CN109692028B

CN109692028B - Ultrasonic surgical instrument

Info

Publication number: CN109692028B
Application number: CN201811613552.4A
Authority: CN
Inventors: 聂红林; 陈继东; 李枝东; 朱国征; 常王桃; 张广斌; 顾晓页
Original assignee: SHANGHAI YISI MEDICAL TECHNOLOGY CO LTD; Yisi Suzhou Medical Technology Co Ltd
Current assignee: SHANGHAI YISI MEDICAL TECHNOLOGY CO LTD; Yisi Suzhou Medical Technology Co Ltd
Priority date: 2018-12-27
Filing date: 2018-12-27
Publication date: 2024-04-05
Anticipated expiration: 2038-12-27
Also published as: EP3903700A1; CN109692028A; US20220087707A1; EP3903700A4; WO2020135254A1

Abstract

The invention provides an ultrasonic surgical instrument for exciting a coagulation function by a side key, which comprises a cutting key, a coagulation key, a cutter bar, a clamp, a sleeve component, a grab handle and an internal structure thereof, wherein the cutting key is pressed by an index finger to excite the cutting function, and the coagulation key is pressed by a thumb to excite the coagulation function. The invention can reduce misoperation of doctors in the actual operation process and relieve fatigue. Meanwhile, the side key activates the blood coagulation function to give consideration to the use habit of the left hand and the right hand of doctors, and doctors who are good at operating the device by the left hand and the right hand can conveniently use the device.

Description

Ultrasonic surgical instrument

Technical Field

The invention relates to an ultrasonic surgical instrument, in particular to an ultrasonic surgical instrument with a side key for exciting a coagulation function.

Background

With the popularity of minimally invasive surgery, ultrasonic scalpels have become a conventional surgical instrument. The ultrasonic surgical knife mechanically oscillates the knife head at a certain ultrasonic frequency through the ultrasonic frequency generator, so that water molecules in tissues are vaporized, protein hydrogen bonds are broken, cells are disintegrated, the tissues are cut or coagulated, and blood vessels can be closed. The ultrasonic surgical blade completes tissue cutting and coagulation simultaneously and has less lateral thermal damage.

The ultrasonic surgical knife mainly comprises an ultrasonic frequency generator, a transducer and surgical instruments. The ultrasonic frequency generator emits an oscillating electric signal, the transducer converts the oscillating electric signal into mechanical vibration, and the surgical instrument cuts and coagulates tissues by using the mechanical vibration of the transducer. The surgical instrument is generally composed of a cutter bar, a clamp forming a clamping structure with a cutter head (a cutting part of the head of the cutter bar), a sleeve surrounding the outside of the cutter bar, a grab handle and a grabbing mechanism. The cutter bar transmits the mechanical vibration of the transducer to the cutter head; the cutter head and the clamp are matched to clamp tissues to realize the functions of cutting and coagulation; the sleeve separates the cutter bar from the outside to protect and support the cutter bar, and forms a connecting rod mechanism with the clamp to drive the clamp to be closed and opened; the grab handle and the grabbing mechanism are held by hands of doctors, can operate the clamp to open and close, and the ultrasonic frequency generator can be controlled by the switch key to start or stop outputting oscillating electric signals, which are commonly called a cutting key and a coagulation key. As the name suggests, the cutting key mainly completes the tissue stripping and cutting functions, the coagulation key mainly completes the blood vessel coagulation function, and the frequency of using the cutting function in the actual operation process is higher than that of the coagulation function.

At present, most of cutting keys and coagulation keys of ultrasonic surgical instruments are arranged at the front finger pressing part of an ultrasonic surgical knife, the excitation function is realized by pressing the index finger, misoperation of a doctor is easy to occur in the use process, the frequency of the cutting function is higher than that of the coagulation function in the actual surgical process, the index finger finishes the two key functions for a long time and mutually switches, fatigue is easy to cause, and the risk of false triggering is further increased.

In order to solve the problem of false triggering, the existing ultrasonic surgical instrument designs a plurality of pawl convex points on one key and designs the other key to be a smooth surface. In the operation, the doctor needs to confirm the cutting key or the coagulation key through the convex points before excitation, and then carries out tissue stripping or coagulation operation. This can reduce the mistake to trigger the risk to a certain extent, but can't avoid the forefinger to accomplish two kinds of button functions and the tired that mutual switching brought for a long time, in addition, long-time pressing pawl bump, the finger slightly has the painful sense. There is also the design scheme that ultrasonic surgical instrument will cut and coagulate the button and all arrange in ultrasonic scalpel side rear, through pressing the thumb excitation coagulate and cut the button, but need perk when the thumb is pressed is higher than normal position, and the operation degree of difficulty of thumb obviously increases. Both the coagulation key and the cutting key are activated by thumb presses, and there is also a risk of false triggering. In order to avoid confusing two keys, one of the keys is arranged on the side of the device, but the keys are in a form of a side vertical direction, the comfort of thumb operation is not high, and a detailed circuit switching scheme is not described in the patent.

Disclosure of Invention

In order to solve the technical problems, reduce false triggering of doctors in the actual operation process and relieve fatigue, according to one aspect of the invention, an ultrasonic surgical instrument is provided, which comprises a cutter bar, a first key, a second key, a grab handle, a transmission mechanism and other internal structures, wherein the first key is positioned in front of the instrument, the second key is positioned on the inclined side surface of the instrument, and the first key and/or the second key can realize sliding or rotation of a certain stroke.

Preferably, the first key is a cut key, and the second key is a coagulation key.

Further, the handle comprises a housing including a left housing, a right housing and other parts.

Further, the index finger presses the cutting key to excite the cutting function, and the thumb presses the coagulation key to excite the coagulation function.

Further, the second keys can be symmetrically arranged on inclined planes at two sides of the instrument.

Further, the second key rotates around the rotating pin shaft, the rotating pin shaft penetrates through the second key mounting hole, and two ends of the second key are respectively mounted on the rotating pin shaft holes of the left and right shells.

Further, the rotating pin shaft penetrates through the transmission mechanism, and the second key is connected with the transmission mechanism in parallel.

Further, the limiting surface of the second key is limited by the limiting plane of the shell of the grab handle, so that the second key can only rotate around the rotating pin shaft.

Further, a circuit board is arranged in the grab handle, and the first key and the second key realize the excitation function by pressing the circuit board.

Furthermore, the first key and/or the second key can realize sliding with a certain stroke, and false touch triggering is prevented.

Further, the first key is arranged in the mounting groove, the mounting groove is composed of a guide chute, an upper guide table and a lower guide table, and the guide boss of the first key slides in the guide chute.

Further, an elastic mechanism is arranged between the first key, the second key and the circuit board.

Preferably, the elastic mechanism may be one or more of a leaf spring, a shrapnel, a spring, and the like having an elastic structure.

Further, the elastic mechanism is installed and fixed on the groove, the seam and the table of the left and the right shells of the grab handle and the combined structure thereof.

Further, the first excitation metal spring sheet and the second excitation metal spring sheet on the circuit board are respectively arranged on two sides of the circuit board, so that the pressing excitation of the first key and the second key in opposite directions is realized.

Further, the circuit board is composed of a flexible board and a hard board, the flexible board is connected with the external signal structure component of the surgical instrument, and the hard board is fixedly arranged in the circuit board mounting grooves of the left and right shells of the grab handle.

Further, the elastic mechanism is of a split structure, and rebound of the first key and rebound of the second key are respectively achieved.

Further, the elastic mechanism is of an integrated structure, and rebound of the first key and the second key is achieved simultaneously.

Furthermore, a limit boss is designed on the shell and/or the first key and/or the second key, so that the keys are prevented from being damaged by the structure caused by overpressure.

Furthermore, a limit boss is designed on the shell and/or the first key and/or the second key, so that a certain gap is formed between the contact surface and the shell.

In another aspect, a method of operating an ultrasonic blade surgical instrument is provided. Specifically, the first key positioned right in front of the instrument is pressed and excited by the index finger, and the second keys positioned on the two oblique sides of the instrument are pressed and excited by the thumb.

Further, the second key can rotate around the rotating shaft, and the rotating stroke is 1-30 degrees.

By the structural arrangement, the invention has the following beneficial effects:

firstly, the false triggering frequency of the index finger when switching the cutting function and the coagulation function is reduced;

secondly, the thumb shares coagulation excitation operation, so that the comfort level of a cutting key is improved and the fatigue of an index finger is relieved;

and thirdly, the front cutting key and the coagulation key with the side inclined surface are designed with a certain sliding stroke to trigger, so that the operation comfort of doctors is further improved, and the risk of false touch is reduced.

Meanwhile, the side key activates the coagulation function to give consideration to the use habit of the left hand and the right hand of doctors, and doctors who are good at operating the device by the left hand and the right hand can conveniently use the device.

Drawings

The accompanying drawings are included to provide a further understanding of the application and are incorporated in and constitute a part of this specification, illustrate and not limit the application.

FIG. 1 is a schematic diagram of an ultrasonic surgical instrument system;

FIG. 2 is a schematic illustration of the operative configuration of an ultrasonic surgical instrument;

FIG. 3 is a schematic view of the ultrasonic surgical instrument;

FIG. 4 is a schematic functional diagram of an ultrasonic surgical instrument key;

FIG. 5 is a schematic view of an ultrasonic surgical instrument cutting key installation;

FIG. 6 is a schematic view of an ultrasonic surgical instrument coagulation key installation;

FIG. 7 is a schematic diagram of the ultrasonic surgical instrument circuit board and leaf spring mounting;

fig. 8 is a schematic diagram of a circuit board structure of an ultrasonic surgical instrument.

Detailed Description

The present application will be further described with reference to the following detailed description, wherein the drawings are for illustrative purposes only and are shown in schematic drawings, rather than physical drawings, and are not to be construed as limiting the present patent, and in order to better explain the detailed description of the present application, certain components of the drawings may be omitted, enlarged or reduced, and do not represent the size of the actual product, and it will be understood by those skilled in the art that certain well-known structures in the drawings and descriptions thereof may be omitted, and that all other detailed embodiments obtained by those skilled in the art without making creative efforts fall within the scope of protection of the present application based on the detailed description in the present application.

The ultrasonic surgical instrument system is shown in fig. 1 and mainly comprises an ultrasonic frequency generator 1, a transducer 2 and a surgical instrument 3. Wherein the ultrasonic frequency generator 1 emits an oscillating electrical signal, the transducer 2 converts the oscillating electrical signal into mechanical vibrations, and the surgical instrument 3 cuts and coagulates tissue by means of the mechanical vibrations of the transducer 2.

As shown in fig. 2, the surgical instrument 3 includes: the rotary thumb wheel 4, coagulation key 5, grip 6, cutting key 7, trigger 8, knife bar 31, clamp 32, and sleeve assembly 33. Wherein the cutter bar 31 and the clamp 32 forming the clamping structure realize ultrasonic cutting and coagulation, the sleeve assembly 33 plays roles of isolating, protecting and supporting the cutter bar 31 from the outside, and the grab handle 6 comprises a transmission system, a trigger reset, an electronic device and the like. By holding the trigger 8, the inner sleeve of the sleeve assembly 3 can be driven to move through the transmission assembly in the grab handle 6, and the inner sleeve can move to realize the closing of the clamp 32 and the cutter bar 31. Otherwise, the opening action of the clamp is realized. The circumferential rotation of the rotary thumb wheel 4 drives the sleeve assembly 33, the cutter bar 31 and the clamp 32 to rotate, so that a doctor can conveniently adjust proper cutting and coagulation angles.

The arrangement of the coagulation key 5 and the cutting key 7 is shown in fig. 2, the coagulation key 5 being located on the oblique side of the surgical instrument 3. The surgical instrument is held, the thumb is tilted slightly, and then the coagulation key is stirred to realize the coagulation excitation function, wherein the stroke angle is 0-30 degrees, and the preferable stroke angle is 5-10 degrees. The cutting button 7 is located directly in front of the surgical instrument 3. The cutting excitation function can be realized by pressing the index finger.

Fig. 3 shows the surgical instrument 3 and its internal structure, as the surgical instrument 3 includes a rotary thumb wheel 4, a coagulation key 5, a cutting key 7, a trigger 8, and a grip 6, and internal device leaf springs 61, rotary pins 62, a circuit board 64, a slider 65, etc. are mounted into corresponding limit structures of a right housing 63 and a left housing 66 (hidden, visible in fig. 2) of the grip 6. The rotating pin shaft 62 simultaneously passes through the mounting holes of the coagulation key 5, the trigger 8 and the sliding block 65, and the bosses of the right shell 63 and the left shell 66 respectively limit the movement of the key 5, the trigger 8 and the sliding block 65, but do not affect the coagulation key 5, the rotation of the trigger 8 when the coagulation key 5 is excited in rotation and the sliding of the sliding block 65 driven by the trigger 8 are not affected, so that the closing of the clamp 32 and the cutter bar 31 is not affected. Therefore, the position of the rotating pin 62 realizes the parallel connection of the coagulation key 5, the trigger 8 and the sliding block 65, and simultaneously realizes the rotation or sliding without interference, thereby reducing parts, ensuring compact structure, compressing structural space and simplifying assembly process.

The key functions of the surgical instrument 3 are schematically shown in fig. 4, and the cutting key 7 and the coagulation key 5 are respectively located on both sides of the circuit board 64. As shown, the cut key 7 is mounted in the cut key mounting groove 631 of the right housing 63, the leaf spring 61 is mounted in the leaf spring groove 632 of the right housing 63, and the circuit board 64 is mounted in the circuit board mounting groove 633 of the right housing 63. The coagulation key 5 is mounted on the right housing 63 by a rotation pin 62, and the rotation pin 62 is mounted in a pin mounting hole 634 of the right housing 63. When the thumb is pressed, the coagulation key 5 can rotate around the rotation pin 62. When the index finger presses the cutting key 7, the left elastic force of the leaf spring 61 is overcome, and then the cutting key is pressed to the circuit board 64, so that cutting excitation is realized; when the index finger releases the pressing force, the leaf spring 61 will rebound the cut key 7. When the coagulation key 5 is rotated, the right elastic force of the leaf spring 61 is overcome, and then the coagulation key is pressed to the circuit board 64, so that coagulation excitation is realized; when the thumb releases the pressing force, the leaf spring 61 bounces the coagulation key 5. The left casing 66 and the right casing 63 of the grip are almost symmetrical, and the cutting button 7, the leaf spring 61, the circuit board 64, the coagulation button 5, and the like are fixed.

The structural installation schematic of the cutting key is shown in fig. 5. The cut key mounting groove 631 shown in fig. 4 is composed of an upper guide table 6311, a lower guide table 6312, and a guide chute 6313 of fig. 5. When the index finger presses the index finger contact surface 71 of the cut key 7, the guide boss 72 of the cut key 7 slides in the guide chute 6313 of the right housing 63, while the upper limit surface 74 and the lower limit surface 75 of the cut key 7 are respectively constrained by the upper guide table 6311 and the lower guide table 6312 of the right housing 63, reducing the skew of the cut key 7. After the cutting key 7 slides for a certain stroke by the forefinger, the cutting key spring contact surface 73 of the cutting key 7 contacts the leaf spring 61, thereby increasing the hand feeling. When the cutting excitation boss 76 of the cutting key 7 touches the circuit board 64, cutting excitation is achieved. In order to protect the index finger from being damaged by overvoltage, the circuit board 64 and the mounting and fixing structure thereof, a stop block 6314 is arranged on the right casing 63 to limit the maximum stroke of the cutting key 7. The left housing 66 of the handle 6 has a corresponding symmetrical structure.

The structural installation schematic diagram of the coagulation key is shown in fig. 6. The rotation pin shaft 62 passes through the two mounting holes 51 and 52 of the coagulation key 5, two ends of the rotation pin shaft are respectively arranged in the rotation pin shaft hole 634 of the right shell 63 and the rotation pin shaft hole 662 of the left shell, the limiting surface 55 of the coagulation key 5 is limited by the limiting plane 631 of the right shell 63, and the corresponding left shell 66 is also provided with a symmetrical structure, so that the coagulation key 5 can only rotate around the rotation pin shaft 62. The lower limit boss of the coagulation key 5 and the upper limit boss 632 of the right shell 63 limit the rotation angle of the coagulation key, and ensure that the thumb contact surface 55 of the coagulation key 5 is not touched with the limit groove 661 of the left shell 66, and the corresponding right shell 63 is also of a symmetrical structure. When the thumb presses the thumb contact surface 55 of the coagulation key 5, the coagulation excitation boss 53 on the coagulation key 5 rotates, and finally touches the circuit board 64 to realize coagulation excitation.

As shown in fig. 7, the schematic mounting diagram of the circuit board 64 and the leaf spring 61 is shown, and the circuit board 64 and the leaf spring 61 are sequentially mounted in the corresponding circuit board mounting groove 633 and leaf spring groove 632 in the direction of the black arrow in the drawing, so that the right-hand schematic structural diagram of fig. 7 is obtained, and the circuit board mounting groove 633 is an oblong groove having a cross-sectional shape similar to that of the circuit board 64. The leaf spring pocket 632 is formed of a leaf spring pocket first upper boss 6321, a leaf spring pocket second upper boss 6322, and a leaf spring pocket lower boss 6323, securing the resilient leaf spring 61 in the opposing gap by a staggered arrangement. The leaf spring 61 is inserted into the leaf spring slot 632 and stops when the leaf spring longitudinal stop 613 touches the leaf spring stop 6324, thereby limiting the positions of the cutting and coagulation actuation tabs 611, 612 on the leaf spring 61. The cutting excitation boss 76 of the cutting key 7 passes through the cutting excitation boss groove 611, and the coagulation excitation boss 53 of the coagulation key 5 passes through the coagulation excitation boss groove 612. As shown in fig. 7, the leaf spring 61 may be divided into three parts of a leaf spring cutting counter spring 614, a leaf spring coagulation counter spring 615 and a leaf spring fixing piece 616. Wherein the first convex hull 6141 of the leaf spring cut counter-spring 614 contacts the cut key spring contact surface 73 of the cut key 7 and the second convex hull 6151 of the leaf spring coagulation counter-spring 615 contacts the coagulation key spring contact surface 57 of the coagulation key 5, the leaf spring fixing piece 616 is confined within the leaf spring slot 632.

The structure of the circuit board 64 is shown in fig. 8. The circuit board 64 is connected to the interface assembly 67 of fig. 3, the interface assembly 67 of fig. 3 is connected to the transducer 2 of fig. 1, and finally to the ultrasonic frequency generator 1 of fig. 1 by means of a flexible board 643 in combination with a rigid board 644. When the cutting key 7 and the metal elastic sheet 641 or the coagulation key and the metal elastic sheet 642 are excited, the mechanical vibration of the cutter bar 31 is controlled by the ultrasonic frequency generator, so that the cutting and coagulation functions are realized. The compact double-sided mounting mode is adopted, the cutting key metal elastic sheet 641 is arranged on the front side surface of the hard plate 644, the coagulation key metal elastic sheet 642 is arranged on the rear side surface of the hard plate 644, so that the mounting space can be saved, and meanwhile, the key excitation in two directions is satisfied. When the cutting excitation boss 76 of the cutting key 7 presses the cutting key metal elastic sheet 641 for a certain stroke, cutting excitation is realized; after the excitation is finished, the cutting excitation boss 76 of the cutting key 7 is separated from the metal elastic sheet 641 of the cutting key, and then the cutting excitation is closed. Similarly, when the coagulation excitation boss 53 of the coagulation key 5 presses the metal spring plate 642 of the coagulation key for a certain stroke, coagulation excitation is realized; after the excitation is finished, the coagulation excitation boss 53 of the coagulation key 5 is separated from the coagulation key metal spring 642, and then the coagulation excitation is closed.

It should be noted that, the embodiments in the drawings are merely representative examples of the present invention, and those skilled in the art will readily understand that the scope of the present invention is not limited to the embodiments in the drawings, and that the combinations, modifications and variations of the embodiments in the drawings fall within the scope of the present invention.

The foregoing disclosure is illustrative of the present invention and is not to be construed as limiting the scope of the invention, which is defined by the appended claims.

Claims

1. The ultrasonic surgical instrument comprises a cutter bar, a first key, a second key, a grab handle, a transmission mechanism, a trigger and other internal structures, and is characterized in that the first key is positioned right in front of the ultrasonic surgical instrument, the second keys are positioned on the inclined side surfaces of the ultrasonic surgical instrument, the two second keys are symmetrically arranged on the two inclined side surfaces of the ultrasonic surgical instrument, the first key and/or the second key can realize sliding or rotating with a certain stroke, the first key is a cutting key, and the second key is a coagulation key;

the two second keys rotate around a rotating pin shaft, one rotating pin shaft penetrates through the two second keys and the mounting hole of the trigger, two ends of the rotating pin shaft are respectively mounted on rotating pin shaft holes of the left shell and the right shell of the grab handle, and one rotating pin shaft realizes the parallel connection of the two second keys and the trigger.

2. The ultrasonic surgical instrument of claim 1, wherein the rotation pin passes through the transmission mechanism to effect parallel connection of the second button and the transmission mechanism.

3. The ultrasonic surgical instrument according to claim 1 or 2, wherein the limiting surface of the second key is limited by a housing limiting plane of the grip such that the second key can only rotate about the rotation pin.

4. The ultrasonic surgical instrument according to claim 1 or 2, wherein a circuit board is provided in the grip, and the first key and the second key realize an excitation function by pressing the circuit board.

5. The ultrasonic surgical instrument of claim 4, wherein a spring mechanism is disposed between the first and second keys and the circuit board.

6. The ultrasonic surgical instrument of claim 5, wherein the spring mechanism mounts slots, slits, tables, and combinations thereof secured to left and right housings of the handle.

7. The ultrasonic surgical instrument according to claim 1 or 2, wherein the first key is placed in a mounting groove, the mounting groove is composed of a guide chute, an upper guide table and a lower guide table, and a guide boss of the first key slides in the guide chute.

8. The ultrasonic surgical instrument of claim 4, wherein the circuit board is provided with a first excitation metal spring and a second excitation metal spring, which are respectively arranged at two sides of the circuit board, so as to realize the pressing excitation of the first key and the second key in opposite directions.

9. The ultrasonic surgical instrument of claim 4, wherein the circuit board comprises a flexible board and a hard board, the flexible board is connected with the external signal structure component of the surgical instrument, and the hard board is fixedly arranged in the circuit board mounting grooves of the left and right shells of the grab handle.

10. The ultrasonic surgical instrument of claim 5, wherein the elastic mechanism is a split structure that achieves rebound of the first key and rebound of the second key, respectively.

11. The ultrasonic surgical instrument of claim 5, wherein the elastic mechanism is a unitary structure that simultaneously effects the rebound of the first key and the second key.

12. Ultrasonic surgical instrument according to claim 1, characterized in that a limit boss is designed in the housing of the grip and/or in the first key and/or in the second key, preventing the keys from being damaged by structural damage caused by overpressure.

13. Ultrasonic surgical instrument according to claim 1, characterized in that a limit boss is designed in the housing of the grip and/or the first key and/or the second key, so that the contact surface has a certain clearance with the housing.